Its a shame that there is so much anti-Obama propaganda in this thread are there are good questions out there about how much change we'll actually see:

Drug Industry to Run Ads Favoring White House Plan

By DAVID D. KIRKPATRICKPublished: August 8, 2009

WASHINGTON — The drug industry has authorized its lobbyists to spend as much as $150 million on television commercials supporting President Obama’s health care overhaul, beginning over the August Congressional recess, people briefed on the plans said Saturday.

The unusually large scale of the industry’s commitment to the cause helps explain some of a contentious back-and-forth playing out in recent days between the odd-couple allies over a deal that the White House struck with the industry in June to secure its support. The terms of the deal were not fully disclosed. Both sides had announced that the drug industry would contribute $80 billion over 10 years to the cost of the health care overhaul without spelling out the details.

With House Democrats moving to extract more than that just as the drug makers finalized their advertising plans, the industry lobbyists pressed the Obama administration for public reassurances that it had agreed to cap the industry’s additional costs at $80 billion. The White House, meanwhile, has struggled to mollify its most pivotal health industry ally without alienating Congressional Democrats who want to demand far more of the drug makers. White House officials could not immediately be reached for comment.

Many Democratic lawmakers have railed for years against what they consider the industry’s excessive profits and pointedly insisted in recent days that they do not feel bound by the White House’s commitments.

Sources briefed on the drug industry’s plans, speaking on condition of anonymity because the details remain confidential, say top officials of the industry’s trade group, the Pharmaceutical Research and Manufacturers of America, or PhRMA, are scheduled to meet next week to finalize its fall plans. The final budget could be less or more than what was authorized, the sources said.

By comparison, President Obama’s presidential campaign spent about $236 million on television commercials while the campaign of the Republican candidate, Senator John McCain of Arizona, spent about $126 million. Few expect the opponents of the health care overhaul to muster as much advertising muscle as its backers, including sympathetic business groups, labor unions and ideological allies. The drug makers stand to gain millions of new customers from the expansion of health care coverage.

Ken Johnson, a spokesman for PhRMA, declined to discuss the specific sums. “Our board has agreed to make a significant investment in support of comprehensive reform,” he said. “Our August plan is pretty much in place, but we have not finalized all the details of the fall campaign.” He said it would include grassroots outreach as well. The scale of the drug industry’s plans was first reported Saturday by The Associated Press.

The drug industry has already contributed millions of dollars to advertising campaigns for the health care overhaul through the advocacy groups like Healthy Economies Now and Families USA. It has spent about $1 million on similar advertisements under its own name.

All of the commercials closely echo common Democratic themes about medical care for all, consumer protection and “health insurance reform.” Some supporters of the overhaul have hired public affairs and advertising firms with close ties to the White House and Senate Democrats, including GMMB, which worked on the Obama campaign, and AKPD, which previously included David Axelrod, who is now the president’s top political adviser.

In another sign of the urgency gripping the pro-health care reform camp, billionaire George Soros has pledged to sink $5 million into the fight, the group getting the money confirmed.

Soros — whose operation carefully guards the privacy of such donations — made the pledge to Health Care For America Now, the leading coalition of pro-reform groups, unions and providers, HCAN chief Richard Kirsch confirmed in an email that was forwarded to me.

Kirsch was asked by a prominent liberal blogger to comment for a post on Soros’ $5 million pledge, which the blogger had heard about. “Thanks for the heads up,” Kirsch emailed in reply. “HCAN is pleased to be supported by people and organizations who support our campaign to win quality, affordable health care for all.”

The blogger, who didn’t end up writing about the donation, passed the email along, and an HCAN spokesperson didn’t dispute the email or the figure when I asked about it.

The Soros pledge is noteworthy, because both sides will seize on it. The right will say it shows the real astroturfing is coming from the pro-reform side — billionaire bogeyman Soros is bankrolling this fight!

The left will cite the donation to demand that HCAN show real results. Some on the left, such as blogger Jane Hamsher, have been asking why heavily-bankrolled HCAN hasn’t been able to secure more commitments from Dem members of Congress to stand firm behind a public option.

HCAN officials regularly appear at a big weekly meeting of progressive groups — the one where Rahm Emanuel famously demanded last week that groups stop attacking other Dems. The question is whether HCAN will heed Rahm’s command and refrain from pressuring Dems to stand up for core reform principles. If so, the question becomes, What are you using all this money for?

The very fact it is "so important" to them to have this Healthscam Bill passed, is the one reason it is "so important" that it does not. It is probably .001% health plan and the rest "takeover."

How do we counter a $5 million push? This is my question. Obama supporters are so blind. Our countrymen are in such need of basics and things like health care. Indeed, what do we have if we don't have our Health? So, I guess I can understand the "blindness."

It is nwo operations right out of the Communist Manifesto to divide the populace in getting us to fight amongst each other on petty issues. This is accomplished by false-empowerment of groups through their very personal thoughts.

Politically correct? I am offended about Obama's "Moms go back to school." What about Dads? What about childless women? oh. He can't say "women" because it is politically incorrect. But "Moms" evokes an emotion and acceptance. Who would be against "Moms" huh?

In yet another in a series of evolving statements and backtracks, an official with the country's major pharmaceutical lobby said on Monday that it never struck a "quote, unquote secret deal with the White House" that would have prohibited the government from negotiating lower drug prices for Medicare.

"It was never brought up at the meeting," said Ken Johnson the senior vice president for the Pharmaceutical Research and Manufacturers of America, just days after his boss told the New York Times that the White House's commitment to not support price controls was, as far as he was concerned, "a done deal."

Johnson was referencing reports that the White House had agreed to not allow the government to use its purchasing power to lower drug prices in exchange for $80 billion in promised cost savings from Big Pharma over the course of ten years. The White House, on Monday, denied that such a deal was ever discussed.

All of which didn't mean that an arrangement of sorts wasn't implicit in separate discussions. Johnson told the Huffington Post that during negotiations with the Senate Finance Committee PhRMA had made it crystal clear that there were certain provisions it would never support.

"In the beginning, when God created earth, we said we will help pass comprehensive health care reform but we cannot support price controls," he said.

Johnson said that PhRMA negotiated around this understanding with the Senate Finance Committee and its chairman, Sen. Max Baucus, (D-Mont.) and that the White House "blessed" that policy agreement. White House Press Secretary Robert Gibbs has also said the administration supported the deal.

But what kind of arrangement was made between Finance and PhRMA remains vague. The White House has referred reporters to the statement on the Committee's website. But that statement, issued on June 20, 2009, includes no information beyond the $80 billion promised by PhRMA.

On June 22, the President hailed the "deal" as a win-win-win for the pharmaceutical company, American public and the government. "Drug and insurance companies stand to benefit when tens of millions more Americans have coverage," he said. "So we're asking them, in exchange, to make essential concessions to reform the system and help reduce costs. It's only fair."

But industry observers were already raising red flags, predicting that this was an attempt by PhRMA to head off more costly legislation down the road.

"Our initial take is that this is a win for the industry because it appears to short-circuit the prospect of direct government price negotiation," read an analysis by Leerink Swann and Company, a health care equity research company.

Last week, the New York Times and the Los Angeles Times both reported that Leerink Swann's prediction was correct - the White House had "embraced" a package that would limit the government's ability to negotiate lower drug prices. In a subsequent piece by the Huffington Post, administration officials said that any measures that would pursue cuts to prescription drug prices should be considered outside the health-care overhaul legislation.

In the end, both Johnson and the White House may be trying to draw a distinction without a difference. Both PhRMA and the administration are on record saying that $80 billion worth in concessions is an appropriate amount. "We feel comfortable with the amount of money that has been talked about at this point," Gibbs said in response to a question from the Huffington Post last week.

PhRMA is on record saying it would oppose health care legislation that contained "price controls." The White House, meanwhile, said on Monday that it was committed not to include one measure that could achieve those controls: rebates which would have bridged the prescription drug prices between Medicaid and Medicare.

The questions that still need to be answered are: Will PhRMA renege on its $80 billion pledge if Congress passes health care reform that allows the government to negotiate for lower drug prices? And will it abandon its pledge to run $150 million worth of television ads in favor of the president's agenda if it believes price controls are still on the table?

The very fact it is "so important" to them to have this Healthscam Bill passed, is the one reason it is "so important" that it does not. It is probably .001% health plan and the rest "takeover."

How do we counter a $5 million push? This is my question. Obama supporters are so blind. Our countrymen are in such need of basics and things like health care. Indeed, what do we have if we don't have our Health? So, I guess I can understand the "blindness."

It is nwo operations right out of the Communist Manifesto to divide the populace in getting us to fight amongst each other on petty issues. This is accomplished by false-empowerment of groups through their very personal thoughts.

Politically correct? I am offended about Obama's "Moms go back to school." What about Dads? What about childless women? oh. He can't say "women" because it is politically incorrect. But "Moms" evokes an emotion and acceptance. Who would be against "Moms" huh?

I am so sick of their evil garbage.

More bs. To the conservacons its a "health care takeover." Anything that might impinge on their greedy profit margins is "evil" to them. They had their turn in charge and they failed, eight years, hundreds of thousands dead!

The incident didn't happen under Bush that they didn't manage to **** up:

9/11, the Wars in Iraq, Afghanistan, Hurricane Katrina, the Depression we're in right now.

If this is the face of anti-health care reform protest, the GOP has a serious problem.

This unidentified man decided he was doing the Tea Party-anti-reform effort a real solid by hanging freshman Maryland Democratic Rep. Frank Kratovil in effigy [note the creepily expert knotted noose] with a placard "Congress Traitors The American [and a word that looks like "idol"].

The event -- a rally in Salisbury, Md. on the Eastern Shore -- was attended by members of the business-funded Americans for Prosperity, a group that includes James Miller, a Federal Trade Commission chairman and budget director during the Reagan administration.

UPDATE: The rally wasn't officially sanctioned by AFP -- but the group's members attended the protest, which coincided with an AFP health care meeting, says a spokeswoman for the group.

"We held an event the previous night, where this man passed out flyers asking people to join him the next day at the office for a protest. That is how some AFP members ended up coming, but they were disgusted by his behavior. I repeat, this gathering WAS NOT an AFP event or sponsored by us in any way," writes AFP's Amy Menefee.

"Frank has no problem with people letting him know how they feel about legislation or him in general, but of course he feels that this one guy was way out of line and most reasonable people would agree that an effigy doesn’t add anything productive to what is a very important debate," said a Kratovil spokesman.

"He has had a lot of constructive conversations with constituents where he has expressed his concerns with the bill and they have done the same, he prefers to focus on those."

Last month, some anti-energy bill protesters tarred and feathered an effigy of Rep. Alan Boyd (D-Fla.) in Panama City. And some genius hung an effigy of Sarah Palin in L.A. last Halloween.

The pic was snapped by the conservative Salisbury News, which supported the rally but was repulsed by the noose guy.

SBYNews blogger Joe Albero, who apparently took the photo, writes:

My hat is tipped to ALL of the AFP individuals who chose to walk away as they refused to partake in such ignorance and abuse. You know me Folks, I call it like I see it.

I firmly believe in any one's first amendment rights. However, there comes a time when that right is abused and IMHO this is one of them.

To The Kratovil Family, my apologies for posting this image but it had to be done and these people had to be called out for their actions.

h/t Washington Independent

UPDATE: As it turns out, the dangling of a noose has distant but painful historical resonance on the Eastern Shore.

The Salisbury area was the site of the last two racial lynchings that took place in the state of Maryland -- both in the 1930s, according to Polly Stewart. a former Salisbury University professor interviewed by NPR earlier this year.

Stewart, a folklorist who researched the crimes, detailed the reaction of predominantly-white local historical society when she confronted them with evidence of the lynchings in the mid-1980s:

"I thought that because I was in a position of prestige at the university, or the college then, and because I was socially friendly with a lot of this people, I would be able to present to them some theory which would explain why the lynchings had happened... [W]hat did happen was that I was attacked. They were furious with me. They were in flames. They were just shaking with rage, some of them.

She added, "[T]he result of it was really that I was iced out of the upper crust for the next 20 years. I was there for 30 years and 20 of those years I was - my name was mud."

President Obama was in full campaign mode today in Portsmouth, NH. At the townhall style meeting he vowed to put to bed all the "misinformation and scare tactics" out there that have lead to waning support for his health care plan.

Here is what he said his plan will do. Insurance companies would have to cover you regardless of pre-existing conditions. There will be no limits on coverage by year or by lifetime. There will be limits on co-pays. There will be a public option for health care coverage that will "keep insurance companies honest". Health care costs will come down.

Here are the legitimate concerns that wont be asked or answered by today's adoring crowd. How do you mandate unlimited liability while limiting revenue and expect private sector insurance companies to survive? Although the president has said the public option will not crowd out private insurance companies, how do private companies compete with a publicly supported entity that will be "too big to fail" on day one? Freddie Mac and Fannie Mae are essentially tax payer subsidized mortgage companies. They are still hemmoraging cash and nearly destroyed the entire financial industry. Why is the health care version going to succeed where the mortgage version failed?

At the outset of the meeting, President Obama cited Medicare as a reason that we must pass reform now. He pointed out that Medicare and Medicaid will go broke within ten years if nothing is done. Not twenty minutes later he pointed to Medicare as a hugely successful government run health program that we should emulate. It's proof that "government run" can work. Is it a system on the verge of collapse or a system we should emulate and expand? It can't be both.

He said the rumors of government "death panels" are completely false. It's the insurance companies that ration care based on what's good for their bottom line. Now the government wants to create this public option, which it says will not be tax-payer subsidized. If that's the case how can money be "no object"? If money is a concern, then there will be rationing. Why is government rationed health care better than insurance company rationed health care?

A health care system that gives everyone everything, anytime at a fixed price is just not possible. Worse than that, trying to force the issue could have devastating consequences. The pie in the sky vision the President put forth sounds great. His energetic proclamations make for great campaign sound bites. Now he is in new territory, however. It's time to do the math. Don't tell me your going to give me unlimited, unrestricted top notch health care for life at a fixed affordable rate. Tell me exactly how you propose to make that happen. If it's as simple as passing a bill that says "make it so", why not just pass legislation banning people from getting sick or injured? Problem solved.

Meltdown: Democratic Congressman David Scott of Georgia Goes Berserk at Town Hall

http://www.youtube.com/watch?v=BttTtjhlvmY

Man, they can't wait to start enforcing the hate bill propaganda. I smell it a mile away.

Do they all want to be dictators or am I hallucinating.

Turning on the public, finger pointing, yelling, come on guys this is to much. Isn't it obvious they feel above us, way FN above us. And we are privledged to ask a question.Ya, just sit there like Joe FKhead and clap, or get screamed at.

The aim of totalitarian regimes has always been to keep the 'workers' just well enough, long enough to perform their slave labor to 'retirement' age ... that is per the actuarial tables ... but no longer. A serviceable body and a weak mind is the perfect vehicle to serve the agenda, as far as they are concerned.

What does "Universal Healthcare" mean to the NWO?

It means, "... keep them young bucks strappin' strong ... got to get as much work out of 'em as possible!"

"But them youguns ... no siree! And them old farts too damaged by fluoride and aspartame and vaccines to get the job done ... to hell with 'em!"

Our Moms and Dads ... the Useless Eaters ... do not apply.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Ezekiel Emanuel: Death to Those With Dementia, as Useless Eaters

July 21, 2009 (LPAC)-- Ezekiel Emanuel, the top healthcare adviser at Obama's Budget Office and brother of his chief of staff, believes it is "obvious" that people with Alzheimer's or other forms of dementia (estimated as one of three people who live beyond the age of 65) should be denied health-care, since they are "irreversibly prevented from being or becoming participating citizens." An essay published in the Hastings Center Report (Nov-Dec 1996) by Emanuel, Norman Daniels and Bruce Jennings, says in part:

"This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity - those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberation - are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia."

No wonder President Obama is in such a rush to get his health care reform package through Congress before the August recess. And before the public finds out about Ezekiel Emanuel, special advisor to Peter Orzag, Obama's director of the Office of Management and Budget (OMB), and brother to White House chief of staff Rahm Emanuel.

Emanuel has written in medical journals of how health care should be rationed, with priority given to younger people over seniors and over those suffering from dementia, according to John Goodman, president of the National Center for Policy Analysis (NCPA). Ezekiel also believes that very young children should be lower on the priority list than younger people who have received public educations.

Goodman cites an article Ezekiel co-authored with two other men that appeared in the January 31, 2009, edition of the British medical journal, The Lancet. Goodman also cites a 1996 article by Ezekiel that appeared in The Hastings Report. In the latter, which was titled "Where civic republicanism and deliberative democracy meet," Ezekiel argued for limiting health care for “individuals who are irreversibly prevented from being or becoming participating citizens.” He cited "not guaranteeing health services to patients with dementia” as an example.

Goodman offers additional analysis on his blog of Ezekiel's presence among Obama's health care advisors. Goodman notes that the health care reform legislation now being crafted in Congress includes a provision designed to ration the availability of MRI, CT and other advanced technology scans that often are critical to identifying dangerous diseases at a sufficiently early stage to enable life-extending treatment:

“An example of what can be done is actually in legislation being written on Capitol Hill. Buried somewhere in the 1,000 plus pages is a provision to severely limit what Medicare pays for CT and MRI scans performed in doctors' offices. This would force elderly patients, for example, to go to the hospital for their radiology — where there are often lengthy waits. Patients in rural areas who must travel long distances to get to hospital-based testing facilities may be discouraged from getting the tests done at all.”

“individuals who are irreversibly prevented from being or becoming participating citizens.” Emanuel wrote, “An obvious example is not guaranteeing health services to patients with dementia.”

Goodman notes that the World Health Organization estimates that 25,000 cancer patients die in Britain annually as a result of such restrictions on medical scans

Democrats Seem Set to Go It Alone on a Health Bill Sign in to RecommendBy CARL HULSE and JEFF ZELENYPublished: August 18, 2009 WASHINGTON — Given hardening Republican opposition to Congressional health care proposals, Democrats now say they see little chance of the minority’s cooperation in approving any overhaul, and are increasingly focused on drawing support for a final plan from within their own ranks.

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Steve Pope/Associated PressSenator Charles E. Grassley, a leader in bipartisan talks, at a town meeting on health care reform in Adel, Iowa last week.

A new blog from The New York Times that tracks the health care debate as it unfolds.

More Health Care Overhaul NewsMultimediaVideo Grassley on Overhauling Health Care Interactive Feature A History of Health Care Reform RelatedTackling the Mystery of How Much It Costs (August 19, 2009) Prescriptions: Grassley Calls Obama and Pelosi 'Intellectually Dishonest' (August 18, 2009) Baucus, and the Debate on Health Care, Go West (August 19, 2009) Times Topics: Republican PartyTop Democrats said Tuesday that their go-it-alone view was being shaped by what they saw as Republicans’ purposely strident tone against health care legislation during this month’s Congressional recess, as well as remarks by leading Republicans that current proposals were flawed beyond repair.

Rahm Emanuel, the White House chief of staff, said the heated opposition was evidence that Republicans had made a political calculation to draw a line against any health care changes, the latest in a string of major administration proposals that Republicans have opposed.

“The Republican leadership,” Mr. Emanuel said, “has made a strategic decision that defeating President Obama’s health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day.”

The Democratic shift may not make producing a final bill much easier. The party must still reconcile the views of moderate and conservative Democrats worried about the cost and scope of the legislation with those of more liberal lawmakers determined to win a government-run insurance option to compete with private insurers.

On the other hand, such a change could alter the dynamic of talks surrounding health care legislation, and even change the substance of a final bill. With no need to negotiate with Republicans, Democrats might be better able to move more quickly, relying on their large majorities in both houses.

Democratic senators might feel more empowered, for example, to define the authority of the nonprofit insurance cooperatives that are emerging as an alternative to a public insurance plan.

Republicans have used the Congressional break to dig in hard against the overhaul outline drawn by Democrats. The Senate’s No. 2 Republican, Jon Kyl of Arizona, is the latest to weigh in strongly, saying Tuesday that the public response lawmakers were seeing over the summer break should persuade Democrats to scrap their approach and start over.

“I think it is safe to say there are a huge number of big issues that people have,” Mr. Kyl told reporters in a conference call from Arizona. “There is no way that Republicans are going to support a trillion-dollar-plus bill.”

The White House has also interpreted critical comments by Senator Charles E. Grassley of Iowa, the top Republican negotiator in a crucial Finance Committee effort to reach a bipartisan compromise, as a sign that there is little hope of reaching a deal politically acceptable to both parties.

Mr. Grassley, who is facing the possibility of a Republican primary challenge next year, has gotten an earful in traveling around his home state. At one gathering last week, in a city park in the central Iowa town of Adel, a man rose from the crowd and urged him to “stand up and fight” the Democratic plans. If he does not, the man yelled, “we will vote you out!”

The White House, carefully following Mr. Grassley’s activities, presumed he was no longer interested in negotiating with Democrats after he initially made no effort to debunk misinformation that the legislation could lead to “death panels” empowered to judge who would receive care.

Citing a packed schedule, Mr. Grassley has also put off plans for the bipartisan group of Finance Committee negotiators to meet in either Iowa or Maine, the home of another Republican member of the group, Senator Olympia J. Snowe, before Congress resumes.

Further, Mr. Grassley said this week that he would vote against a bill unless it had wide support from Republicans, even if it included all the provisions he wanted. “I am negotiating for Republicans,” he told MSNBC.

In an interview on Tuesday, Mr. Grassley said he had simply been repeating earlier comments that he would not support a measure that did not have significant Republican support. He said that raucous town-hall-style meetings might have made the job of reaching a compromise harder, but that he had not given up.

“It may be more difficult than it was before,” he said. “I am intent on talking. I am intent on seeing what we can do.”

Administration officials, who maintain that Republicans are badly mischaracterizing the legislation that has emerged from three House committees and the Senate health committee, said they had hoped to achieve some level of bipartisan support. But they are becoming increasingly convinced that they will instead have to navigate the complicated politics among varying Democratic factions.

The officials said the White House hoped to make the case to the American people that it was Republicans who had abandoned the effort at bipartisanship. Republicans countered by saying that they simply opposed the legislation and that the public outcry had validated their view and solidified their opposition.

This week’s careful administration maneuvering on whether a public insurance option was an essential element of any final bill was seemingly part of the new White House effort to find consensus among Democrats, since the public plan has been resisted by moderate and conservative Democrats who could be crucial to winning the votes for passage if no Republicans are on board.

For the second time in two days, Mr. Obama did not mention health care on Tuesday, a marked departure from the aggressive public relations campaign he mounted in July and early August. The White House is striving to stay out of the fray, aides said, until the president can get away on vacation this weekend.

Even as the administration showed some flexibility, angering liberal Democrats who consider a public plan essential, Republicans turned their attacks from the public option to the health care cooperative idea being promoted by some Senate Democrats.

In what Democrats regarded as further evidence that Republicans were not serious about negotiating, Mr. Kyl and Representative Eric Cantor of Virginia, the second-ranking House Republican, described a co-op as a public option carrying another name.

The continuing opposition was noted Tuesday by Robert Gibbs, the White House spokesman, who said of Republicans that at best “only a handful seem interested in the type of comprehensive reform that so many people believe is necessary to ensure the principles and the goals that the president has laid out.”

There are 60 members of the Senate's Democratic caucus -- so why is Sen. Kent Conrad insisting that that there aren't enough votes to pass a public health insurance option as part of comprehensive reform bill?

"The fact of the matter is there are not the votes in the United States Senate for the public option, there never have been, so to continue to chase that rabbit is just a wasted effort," Conrad said on Fox News Sunday.

Conrad, a Democrat from North Dakota (pop. 641,481), is presumably assuming that a bill containing a public option would need 60 votes to overcome a filibuster. But even if that is the case, not a single member of the Democratic caucus -- including Conrad himself -- has actually announced that he or she would support such a filibuster. And a few Republicans -- Susan Collins and Olympia Snowe of Maine -- might not support it either.

"Senator Conrad should leave the vote counting to the leadership," a peeved Democratic leadership aide told the Huffington Post.

Conrad, the Budget Committee chairman, is also a key Finance Committee member, and is one of the bipartisan "Gang of Six" that has taken on the role of lead health care negotiators.

One thing to keep in mind is that there may not be a separate vote on the public option; it could simply come down to an up or down vote on the entire bill, with the public option included. For instance, even if the Finance Committee bill doesn't include a public option, the Democratic leadership, when it combines the bill with the health committee version, could include it. Another outside possibility is that senators could be faced with a bill coming out of conference committee that includes the public option, even if their chamber didn't vote for it initially.

Conrad, somewhat morbidly, appears to be assuming in his whip count that two members of the caucus, Sens. Ted Kennedy (D-Mass.) and Bob Byrd (D-W.Va.), will be too ill to vote. Conrad has previously noted to reporters that both may not be able to vote because of health concerns.

Byrd, however, made it to several votes just before recess. And health care reform is the defining policy and political goal of Kennedy's life. If both showed up, someone from the Democratic caucus would have to break ranks to kill the public option. Who would do it?

Even Conrad himself is not a definite no. His spokesman said he has yet to take a personal position on the public option.

At least three other caucus members have spoken critically about the public option: Mary Landrieu (La., pop.), Ben Nelson (Neb.) and Joe Lieberman (I-Conn.).

Landrieu, however, has said that despite her opposition, she could still vote for a comprehensive reform package that included a public option, depending on the details. She told the Huffington Post recently that it's too early to say whether she should support a filibuster of a bill that included a public option.

Nelson, too, is leaving his options open, saying that there is no bill yet. He told a local Nebraska official in June that he wouldn't filibuster a public option. (Neb. pop.: 1,783,432.)

Lieberman has also said the he is open to supporting it as part of a broad package.

Sen. Kay Hagan (D-N.C.) previously expressed some doubt about the public option but wound up voting for it in the Health, Education, Labor & Pensions Committee, as did Sen. Jeff Bingaman (N.M.), the third Democrat in the Gang of Six, along with Conrad and Finance Committee chair Max Baucus of Montana (pop. 967,440).

Centrist Pennsylvania Democrat Bob Casey also voted for the public option in the Health, Education, Labor and Pensions Committee; and moderates Claire McCaskill (D-Mo.) and Jim Webb (D-Va.) have publicly signed on to the idea.

In May, six other possible no votes -- Sens. Tom Carper (D-Del.), Mark Warner (D-Va.), Arlen Specter (D-Penn.), Jon Tester (D-Mont.), Blanche Lincoln (D-Ark.) and Maria Cantwell (D-Wash.) -- told the Huffington Post that they were at least open to considering a public option.

When it comes to an up or down vote on the entire bill, one factor all Democrats will surely keep in mind is the cost to their party if health care reform fails.

In a speech in Pittsburgh Thursday to liberal bloggers, former President Clinton argued that the passage of a reform bill will lead to a spike in Democratic approval. By contrast, Democrats paid a high price -- both the House and the Senate -- for failing to reform health care in 1993 and 1994.

And even if a few Democrats either can't make the vote, or defect, three Republicans -- North Carolina's Richard Burr, along with Snowe and Collins -- have said they're open to some form of public option.

"It's okay if you want to have a government option, but you've got to leave the private sector private," Burr told a local paper on Friday. (HuffPost contacted Burr's office and has started the walk-back clock on that one.)

OpenLeft's Chris Bowers has his own whip count going, as does blogger and statistician Nate Silver. They consider a host of alternate scenarios, and reach no firm conclusions, other than with more than 40 firm votes, Democrats could themselves successfully filibuster any attempt to strip the public option out of the full bill

FireDogLake's Jane Hamsher, meanwhile, raises a subject that the Senate doesn't often like to consider: There are, in fact, two chambers of Congress. And House Speaker Nancy Pelosi (D-Calif.) has floated her own vote tally, saying that health care reform without a public option doesn't have the votes.

Rep. Raúl M. Grijalva (D-Ariz.), co-chair of the Congressional Progressive Caucus, responded to the wavering around the public option by reiterating the threat to block reform that doesn't include it.

"As we have stated repeatedly for months now, a majority of the members of the Congressional Progressive Caucus will oppose any healthcare reform legislation that does not include a robust public option. Our position has not, and will not, change," he said. "As Co-Chair of the Progressive Caucus, I look forward to working with my colleagues to develop comprehensive legislation that allows all Americans to choose the healthcare plan that's right for them and their families. But I will not support any bill that does not include a public option."

By David S. HilzenrathWashington Post Staff WriterSaturday, September 19, 2009

A proposal to make preexisting health conditions irrelevant in the sale of insurance policies could help not just the seriously ill but also people who might consider themselves healthy, documents released Friday by a California-based advocacy group illustrate.

Health insurers have issued guidelines saying they could deny coverage to people suffering from such conditions as acne, hemorrhoids and bunions.

One big insurer refused to issue individual policies to police officers and firefighters, along with people in other hazardous occupations.

Some treated pregnancy or the intention to adopt as a reason for rejection.

As Congress and President Obama work on legislation to overhaul the nation's health-care system, one of their main objectives is to stop insurers from denying coverage on the basis of health status. Proposed legislation would prohibit insurers from denying coverage to individuals with preexisting conditions or charging them higher premiums because of their medical history -- practices known as medical underwriting.

Even the insurance lobby has endorsed that goal as part of a larger reform package in which the government would extend coverage to the uninsured, greatly expanding the market for insurance.

Guidelines that insurance companies have written for professionals involved in selling policies offer a glimpse inside the underwriting process.

"What these documents show is the lengths to which insurance companies are willing to go to make a profit," said Jerry Flanagan, health-care policy director of the advocacy group Consumer Watchdog, which distributed the documents Friday. "What it shows is that insurance companies want premiums without any risk."

Uninsurable conditions included pregnancy, and being an "expectant father" was grounds for "automatic rejection." So was having received "therapy/counseling" within six months of the application. There was also this more general disqualifier: "currently experiencing/experienced within the last 12 months symptoms for which a physician has not been consulted."

The PacifiCare document "is completely outdated and predates the acquisition of PacifiCare by United Healthcare," Cheryl J. Randolph, a spokeswoman for the parent company, said by e-mail. She declined to provide current underwriting documents.